Identifying and Improving the Active Ingredients in Pediatric Complex Care

Process Evaluation of a Hub-and-Spoke Model to Deliver Coordinated Care for Children with Medical Complexity across Ontario: Facilitators, Barriers and Lessons Learned

“…Process evaluation frameworks for complex interventions should incorporate clearer guidance that accounts for variations in the context of implementation and intervention modifications, particularly for multi-site interventions ( Evans et al 2019 ). Future research on paediatric complex care should build on current knowledge of its theoretical active ingredients, and investigate how contextual variables could be systematically incorporated into intervention design to achieve intervention effectiveness in adapted settings ( Feudtner and Hogan 2021 ).…”

Implementing a Care Coordination Strategy for Children with Medical Complexity in Ontario, Canada: A Process Evaluation

“…Consistent with other studies, our findings support the development of tertiary-based complex care programs integrated within the community as an essential way to integrate care for CMC across locations, across the care continuum and across service systems [ 7 20 21 ]. The comprehensive care that CMC and their families received includes features that appear to have contributed to improved outcomes in other studies, such as a designated key worker, 24/7 access to an on-call paediatrician or nurse, coordinated care with a multidisciplinary team-based model, timely access and reliable medical assessment and guidance when acute illness episodes arose, development of a care plan and provision of specialty services within the same clinic [ 22 23 24 25 ].…”

Identifying Conditions With High Prevalence, Cost, and Variation in Cost in US Children’s Hospitals

“…Researchers can include children with medical complexity in future studies by including additional safety measures and subgroup analyses. Further, complex care programs that bridge inpatient and outpatient care can reduce hospitalizations, hospital days, and hospital costs in medically complex children …”

“…Further, complex care programs that bridge inpatient and outpatient care can reduce hospitalizations, hospital days, and hospital costs in medically complex children. [41][42][43]…”